From the Guidelines
It is recommended to stop taking Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) for five elimination half-lives of the medication before surgery. Specifically:
- Stop aspirin 7 to 10 days before surgery, as recommended by 1
- For other NSAIDs, the duration to stop before surgery varies:
- Ibuprofen should be stopped for 2 days before surgery, as it has a short elimination half-life 1
- Naproxen (Naprosyn) should be stopped for 2 to 3 days before surgery 1
- Piroxicam (Feldene) should be stopped for 10 days before surgery, due to its longer elimination half-life 1 If you're on prescribed NSAIDs for a chronic condition, consult your doctor before stopping, as they may provide specific instructions or alternative medications. This recommendation is due to NSAIDs' effects on blood clotting, as they inhibit platelet function, which can increase bleeding risk during and after surgery, as noted in 1. Remember to inform your surgeon about all medications you're taking, including over-the-counter drugs and supplements, as they may also affect surgical outcomes. Key considerations include the patient's individual risk factors, such as history of myocardial infarction or cardiac stent placement, and the potential benefits and risks of continuing or stopping NSAIDs, as discussed in 1.
From the Research
Stopping NSAIDs Before Surgery
The decision to stop taking Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) before surgery depends on the type of NSAID and the individual patient's situation.
- According to 2, different NSAIDs should be stopped at varying intervals prior to spinal operations, ranging from 1-10 days.
- The following NSAIDs and their recommended stop times are:
- 1 day: Diclofenac (Voltaran), Ibuprofen (Advil, Motrin), Ketorolac (Toradol)
- 2 days: Etodolac (Lodine), Indomethacin (Indocin)
- 4 days: Meloxicam (Mobic), Naproxen (Aleve, Naprosyn, Anaprox), Nabumetone (Relafen)
- 6 days: Oxaprozin (Daypro)
- 10 days: Piroxicam (Feldene)
- A study published in 3 found that patients taking NSAIDs with half-lives longer than 6 hours had more postoperative bleeding complications, suggesting that patients should stop taking NSAIDs in time to allow elimination of the drug.
- Another study 4 found that short-term use of NSAIDs (10 days or fewer) may be considered relatively safe when prescribed at the most effective dose and for the shortest duration of time.
- However, it is essential to consider the individual patient's situation and the type of surgery being performed, as well as the potential risks and benefits of stopping or continuing NSAID therapy, as noted in 5 and 6.